It can feel like someone threw a switch. Suddenly you’re not sleeping at night, you’re snapping at your family, putting on weight and feeling like you just can’t handle stress like you used to. Is this just the reality of aging?
Yes and no. These are common symptoms that come up in midlife, during the transition through menopause. They often start when women are in their 40s, and can last for up to 10 years. For some the symptoms are extreme. For others, they are more subtle. But almost every woman will observe a shift through this time of life as reproductive hormones decline in an erratic and unbalanced way. Yes – this transition is a natural and inevitable part of aging.
But no – the discomfort is not something you just need to accept. It’s possible to experience a healthy, more comfortable transition. In fact, this transition can be an opportunity to set the stage for health and longevity in the years ahead. Supporting women as they do just that is the focus of my naturopathic practice.
One of the many tools I use to provide this support is bioidentical hormone therapy. In this article, I share my responses to some of the most common questions I’m asked when it comes to the use of hormones in my practice.
What are bioidentical hormones?
Bio-identical hormones are plant-based medications that look exactly like the estrogen and progesterone that our bodies naturally make. They can be used to support hormone levels and provide relief from symptoms that arise when our own hormones are out of balance.
In comparison, non-bioidentical hormones are similar to – but not exactly the same as – our natural hormones. They create a similar response in our bodies compared to our own hormones, but because they aren’t exact, they can come with a different set of side effects. The birth control pill is an example of non-bioidentical hormones.
How can they help?
Most of the symptoms that come up in the menopause transition are due to declining hormone levels, so putting hormones back into the system can be a great strategy to provide relief. Many women I work with have found significant relief from hot flashes, night sweats, brain fog, low energy, anxiety, and sleepless nights. I’ve also seen improvements in joint pain, hair growth, mood, motivation, and libido.
The benefits of using bio-identical hormones reach beyond symptom management. Current research shows connections between the use of bio-identical hormones and better heart health, weight management, blood sugar control, bone density and breast health.
Sounds like a miracle cure. What’s the catch?
It can take time to find the right dose. There can be side effects like breast tenderness, water retention, spotting or bleeding (basically like having a menstrual period again because of increased estrogen levels). Usually, these effects resolve after a few months, as your body re-calibrates to the new hormone levels, but some women find they just don’t tolerate supplemental hormones well.
The real catch is that hormones aren’t a miracle cure at all. They can provide profound symptom relief. But if you want to sleep deeply through the night, achieve healthy weight, increase bone density or improve heart health, you can’t do it by just taking hormones. There is no magic pill that can replace stress management, a healthy diet, or exercise.
Thankfully, most women find that when they start hormones and start feeling better, they find they actually have the capacity to adopt the dietary and lifestyle pieces that are needed to achieve the health they are going for.
Are they safe?
Yes! For many women, prescribed hormones are a safe (and effective) part of their health care plan. But they are not without risk. There are several factors to consider:
- When it comes to long-term risk, the type of hormone makes a difference. Overall, bioidentical hormones are much safer than their non-bioidentical counterparts.
- The way you take it matters. For example, taking estrogen topically (as a cream or gel) rather than orally (as a pill) makes a significant difference in its safety profile. It is important to talk with your prescriber about which form of hormones is safest and most effective for you.
- Timing also matters. There is a “window of opportunity”, a phase of life, when potential complications from taking hormones are at a minimum. In general, this opportunity lies right around the time that the period stops and menopause starts. Increased age doesn’t rule out hormones as an option, but generally risk increases as age increases.
- It’s important to look at the possible effects of not taking hormones. Research continues to reveal potential long-term benefits. For example, bioidentical estrogen, prescribed optimally, can benefit heart and bone health. That means, there may be a risk in not taking it.
The work-up I offer before I prescribe hormones includes a comprehensive look at personal and family history, health goals, lifestyle factors, and assessment of overall health. We look at individual risk of heart disease, cancer, osteoporosis and metabolic disease. These factors are weighed into the risk/benefit assessment and hormone prescription.
In addition, my naturopathic approach rarely stops at the hormone prescription. My recommendation to anyone taking hormones is that it is part of an overall treatment plan that includes:
- Dietary strategies
- Liver support
- Stress management
- Optimal exercise
- Strategies for longevity and healthy aging
But wait. Isn’t it natural for our hormones to decline? Should we really interfere? This question usually sparks great conversations that go beyond the breadth of this article.
I’ll summarize with a couple of things to think about:
Your hormones will naturally decline on their own. If symptoms of this shift occur, the effect on quality of life can be significant. The intent is not to go against a natural transition, but to support the process in order to minimize this effect and optimize quality of life.
Women are living longer than they used to. That means an increased risk for diseases associated with aging. Some of these risks can be mitigated with the use of hormone therapy. One could even argue that by reducing this risk, the use of bioidentical hormones can help women live longer, more natural, disease-free lives.
Your values weigh into the assessment of pros and cons. Ultimately, I encourage all women to seek qualified guidance, ask questions, be informed, and make decisions that feel right for them.
What’s next?
If you’re interested in the option of hormone therapy, work with a healthcare practitioner who has specific training in this field.
If you want more information, feel free to download my free Guide to Bioidentical Hormone Therapy. In it, I answer even more questions, including those about:
- Weight gain
- Breast cancer
- Muscle and bone health
- The “window of opportunity”
If you want to chat with me, book a free 15-minute alignment call to see if working together is a good fit.
Dr.Rachel VandenBerg, ND
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